Life of the Tube

The art of post-intubation management

 

 
 
 

Charlie Eisele, BS, NREMT-PJimmie Meurrens, BS, NREMT-P | | Monday, August 25, 2008


Is the juice worth the squeeze?

We ask ourselves that after every prehospital journal or magazine article we read. When we dive into the literature, we want to come out more knowledgeable and capable of using the information on our next call.

If you're like us, you like to know that you didn't waste 20 minutes or more reading something that's going to take another class or special permission to use. So we promise that after consuming the information in this article, you'll be able to immediately apply it and improve the level of care you deliver in the field.

Wake-Up Call

Nationally recognized EMS textbook author andJEMS contributing author Bryan E. Bledsoe, DO, FACEP, recently wrote, "[Endotracheal intubation] is problematic and the procedure should probably be stopped." He added, "Everybody better get used to LMAs, Combi-Tubes and similar rescue airways because routine prehospital ETI is probably a thing of the past."

For those who haven't heard about recent studies on the success rates and efficacy of prehospital intubation, Bledsoe's comments might seem like a step backward in prehospital medicine. But his concern is valid. Several prominent studies have strengthened a growing concern about this intervention, and as EMS professionals, we can't ignore what the science is showing us.

Specifically, we should note the findings from a St. Luke's-Roosevelt Hospital, Columbia University 2004 study. The researchers found that endotracheal (ET) tubes placed by paramedics in the prehospital setting were incorrectly placed "at a concerning rate


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